Medical conditions travel insurance: Your 11 need-to-knows

Travel insurance for people with pre-existing medical conditions works exactly the same way as insurance for typical travellers and is designed to cover you for the unforeseen such as cancellation or lost luggage.

The only exception is that it also covers the cost of care for any medical condition you may have had in the past or you suffer from currently.

This is not included in typical travel insurance as standard, meaning that specialist cover is vital for holidaymakers with a history of illness, and you'll usually pay more, as insurers consider you to be more of a risk than those with a clean bill of health.

Before you buy pre-existing medical conditions travel insurance, here are 11 things you need to know.

Insurance is about covering unpredictable events

"Why should I get travel insurance, I might not use it?" you may ask. But the whole point is to cover you for the unforeseen – ie, unpredictable events that may occur either before or during your holiday.

You need to accept that, and as it's impossible to predict the future, all you can do is to give it your best shot. To sum up...

Insurance is about making unpredictable events predictable in case the unpredictable happens.

Always declare your medical conditions or you may not be covered

A pre-existing condition is an illness or disease that you have had advice for, symptoms of or treatment for. Different insurers will have their own list of conditions they need to be informed about before you travel – the following are the most common...

Heart conditions (which usually includes high blood pressure)

Cancer

Breathing conditions (including asthma)

Joint and bone conditions

Diabetes

Gastrointestinal condition (problems with your stomach)

Insurers will also need to know about medication, conditions or illnesses that can be linked to your pre-existing condition. For example, an asthmatic who develops a chest infection (connected to being asthmatic) while on holiday will only be insured if the policy includes coverage for asthma.

As you are statistically more likely to fall ill while abroad if you have medical conditions it's important you give a full and frank run down of all your health issues, or those you've had in the past, when you apply for a policy.

If your insurer doesn't know about your medical history any pre-existing conditions will be excluded and you could face a massive bill if you become unwell.

If you have annual cover but later develop a medical condition you need to tell your insurer immediately. Insurers need to know about any condition you currently have, or may have had in the past, so they can accurately price your cover. If you have a condition they do not know about it will not be included as part of your policy, and if you fall ill because of it, you would have to foot the medical bill yourself as they will reject your claim.

Pregnancy is not classed as a pre-existing condition and does not need to be declared to your insurer. You should be covered by most insurers if you have a pregnancy-related emergency abroad providing you have not had any complications and you are less than 37 weeks pregnant or 33 weeks pregnant if you are having twins – but always check as this can vary with different insurers.

It's also recommended you get a letter from your doctor and take this with you, stating how many weeks pregnant you are, along with your travel insurance documents. As pregnancy is not an unforeseen condition it will not be covered by most travel insurers in its later phases.

In January 2015, British couple Lee Johnston and Katie Amos were left facing a medical bill of more than £100,000 after Katie gave birth 11 weeks early. In this instance, their insurer paid out. However, as always, to make sure you are covered, check the terms and conditions of your policy carefully.

You will not need any special sign off from a doctor before you travel if you have pre-existing conditions but your insurer may have to refer back to your doctor for more information when you apply for cover. However, if you are under doctor's orders not to travel but decide to venture overseas anyway, your travel insurance will be invalid.

If you are looking to find cover but are awaiting diagnosis, surgery, treatment or tests, or you have an illness that you have not discussed with a doctor, you will struggle to get cover. In this instance you may have to put your travel plans on hold – especially if the condition is potentially serious.

Buy as soon as you've booked or risk not being covered for cancellation or pre-trip illness

It is never a good idea to wait to the last minute when you are buying travel insurance but this is even more important if you have pre-existing conditions because it may take a bit longer to get it sorted. There's also the risk that your condition gets worse so if you've already got the insurance you'll be covered.

Thinking you don't need to arrange cover yet as your holiday's not for another six months is a big mistake.

In fact, it's even more of a reason to arrange travel insurance, as anything can happen before your trip. Why? It's because travel insurance won't just cover you while you're away, it'll also cover you for cancellation or anything else that might go wrong BEFORE you make your trip.

So the sooner you buy cover, the sooner your holiday is protected.

Never assume all policies are the same

While choosing a travel policy isn't rocket science, don't think you can buy cover without first giving it considerable thought.

This is even more important when looking for policies if you've got pre-existing conditions because they vary greatly and each have their own inclusions and exclusions, limits and excesses.

Before you decide what you are going to buy ask yourself the following questions: Will I be bringing expensive personal belongings? Will I be carrying a relatively large amount of foreign currency? Am I taking part in winter sports? This will help you decide what cover's right for you.

Every travel insurance policy covers different things but all would offer a varying degree of cover on:

Medical cover Unforeseen illnesses, injuries or accidents will be covered under the medical section of your policy, which is absolutely crucial as you have pre-existing medical conditions. This covers the cost of receiving treatment overseas – including dental emergencies in most cases – and repatriation, the cost of having to fly you back to the UK.

On a slightly more morbid note, most policies cover cremation costs or the repatriation of a body should you or someone else covered under the policy die during your holiday.

Cancellation Travel policies also cover cancellation if you can no longer go on your holiday or you need to come back early. However, there needs to be a valid reason for you to abandon your trip. Being made redundant, having to do jury service, or having to take care of a seriously ill family member are among valid reasons.

But if you decide you no longer fancy a trip to the Canary Islands because you would rather go to the Maldives, or you want to return to the UK because you forgot to put EastEnders on series record, your claim will probably be rejected.

Baggage and personal belongings Your travel policy will also cover you if your stuff is lost, stolen or damaged while you are on holiday. Almost everything you take overseas, including computers, phones, cameras and expensive clothing is included – but always check the policy limits. Many providers will also cover you for the loss of a passport, cash or a driving licence.

However, policies can vary greatly both in the amount covered and in the excess – the amount you have to pay towards the claim yourself. For example, items such as cash or expensive goods can be subject to an additional higher excess.

Personal liability Personal liability protects others and their property from accidents you may cause while on holiday. For example, the personal liability element of your insurance would cover you if, during a skiing trip, you crashed into another skier and injured them. Insurers will typically cover you for up to £2m, which is generally more than enough.

Delays Travel schedules are often the victim of adverse weather, so delay cover is one of the more important aspects of travel insurance. Most policies cover against more than just storms, with many including events such as industrial action and mechanical breakdown.

If your flight's been delayed for more than three hours or it's been cancelled you may be able to claim compensation of up to £470 directly from the airline but the reason for the delay or cancellation must be the airline's fault, so bad weather for example, won't count.

This compensation is only for EU-regulated flights. An EU flight is where the flight departed from an EU airport, regardless of the airline OR where an EU airline landed at an EU airport. Under this law, EU airports also include those in Iceland, Liechtenstein, Norway and Switzerland. See our Flight Delay Compensation guide for more info.

If this doesn't apply – perhaps because you flew both from and to an airport outside the EU – you can also try making a claim on your travel insurance policy. Insurers typically pay out for each 12-hour period you've been delayed, but the payouts are often tiny compared to what you can get from your airline so always go down that route if you can.

Like all insurance policies, there are a number of things that providers will not pay out for. Here are the most common:

Alcohol-related injury You may be on holiday to unwind but if you are injured while you are more than just a little tipsy, your insurer is likely to reject your claim. The same goes for drugs. Insurers have different classifications of 'drunk', with some using blood alcohol limits, so check your policy carefully before you buy.

Medical conditions Most insurers will cover you if you have pre-existing medical conditions, especially if it is not severe. If you have a minor health condition, such as mild asthma, you may able to get cover fairly cheaply but if you have a more severe condition, such as cancer, buying insurance will either be more expensive or you may be declined cover entirely.

However, if you fail to tell your insurer and then need treatment for that condition, or a related condition, you won't be covered. So, if you have asthma and don't tell your insurer and, during your holiday, you have an asthma attack or any breathing-related difficulty, you are unlikely to be covered.

You may also struggle to get a claim paid if you ignore advised medication or jabs needed to enter a country. So, if you go to Kenya and decide against getting jabs for Diphtheria, Hepatitis A, Poliomyelitis, Tetanus and Typhoid do not expect your insurer to foot the bill if the worst happens.

Dangerous sports If you are going on an adventure holiday, or you are planning to take a winter sports break, you must get extra cover or a specialist policy. Taking to the Alps for a spot of snowboarding with just a basic travel insurance policy in your bag is a risk not worth taking. If you get injured you could end up paying £10,000s in medical bills.

Unattended possessions Travel insurance will cover your personal possessions when you are abroad but it doesn't mean you can be gung ho with your stuff. If you leave your items unattended and they are then stolen, your insurer will not pay for their replacement.

Travel to dangerous countries The Foreign and Commonwealth Office (FCO) outlines which countries are unsafe for travel. If you travel to a country on the FCO's list your cover is likely to be invalid. Check out the FCO's current travel advice for more.

Insurers will classify your trip as either European or worldwide. Worldwide is often further broken down to either include or exclude the US, with cover that includes the latter usually more expensive due to the high cost of medical treatment in the US.

However, some insurers include destinations such as Egypt and Turkey in Europe, while others offer European policies with the option of including or excluding Spain (which is more expensive and may increase your premium). As always, check your policy carefully to make sure you are getting the right cover.

Annual travel insurance policies will cover you for trips in the UK but there will be restrictions, especially to medical care, so make sure you check your terms and conditions carefully before you buy.

You will be able to claim for cancellation, lost luggage, lost money and the other common travel insurance benefits and the number of days per trip is likely to be the same as any overseas holiday taken under the policy. However, insurers have different definitions of a UK trip.

For instance, LV* covers UK trips but only if you have pre-booked your accommodation or are more than 25 miles from your home or your journey involves a sea crossing, Aviva* will cover you if your trip includes at least two nights in pre-booked accommodation.

In addition, because you will typically be entitled to NHS treatment in the UK, the medical expenses limit (which can be as high as £10m for trips abroad) will be greatly reduced for UK trips.

Single trip policies, meanwhile, are broadly similar to annual policies but the number of days per trip will depend on the cover you have opted for.

Remember to check your T&Cs carefully to see what you and aren't covered for.

An excess is the amount you have to pay towards any claim you make. For example, if you cancel a trip and are entitled to £3,000 back from your insurer but have a £500 excess you will only receive £2,500.

However, many travel insurance products have separate excesses for different sections of the policy. For instance, some providers may make you pay an excess on both stolen cash and luggage. So if your suitcase was nicked and your wallet was inside you would have to pay an excess on both.

If you have a group policy you may also have to pay an excess for each person for any loss that impacts your entire party, such as cancellation. It is important to check all excesses so you know exactly what you will have to pay if you make a claim.

Most travel insurance policies are designed to cover package holidays, as historically that's how 90% of us booked our holidays, and not all providers have kept up. This leaves them ill-equipped to cover DIY trips, where flights and accommodation are booked separately.

The biggest issue is a lack of cover for knock-on consequences. If a policy covers scheduled airline failure, for example, and the airline goes under, you'll typically be able to claim for the flights and any consequential losses, such as hotel costs. Without this cover, you'll lose the money you paid for it.

To beat this, you need a policy that specifically covers 'indirect loss' or 'scheduled airline failure'. Check the small print as more insurers are including this cover as standard or as an optional extra.

Remember, package holidays feature extra ATOL and ABTA protection, which you don't get on DIY trips. If you're booking a DIY trip, if the additional fee isn't too expensive, book on a credit card (repaid in full to avoid interest) and then you get Section 75 protection for anything costing over £100, or on debit card to be eligible for Chargeback.

As with any insurance product, check all the terms, conditions, exclusions and inclusions before you buy. Travelling without the right cover can leave you seriously out of pocket. As a traveller with pre-existing medical conditions you MUST check that all conditions you have now or have had in the past are declared and covered.

Remember to check your excesses too. High excesses may result in a cheaper policy but should only be considered if you can afford to front a large portion of the costs of any claim yourself.

Single trip policies MAY be your most affordable option

If you have pre-existing conditions buying an annual policy may be prohibitively expensive. Get quotes for both single trip and annual cover and work out what will be most cost effective.

If it is cheaper to buy an annual policy, and you know you will be making a number of trips, opt for that instead. Of course, this varies depending on where you're travelling to and for how long but if you also have extra trips during the life of the policy, you already have the cover in force.

Annual cover will insure you for an unlimited number of trips over a 12-month period. However, you may be restricted for the number of days you can be on holiday for per trip – it is often 31 days but can sometimes be as low as 17 or as high as 90.

Groups policies are based on the oldest traveller so separate cover could be cheaper

Group insurance premiums are based on the oldest traveller or the person deemed to be the highest risk, such as someone with pre-existing medical conditions. Insurers become more selective under these circumstances, and hike up premiums.

A separate policy for you may be the best option to avoid everyone paying over the odds but always check both.

Here's an example:

A family of four – A 45-year-old with diabetes and on medication for high blood pressure, 40-year-old with a clean bill of health and two children under 18 – want a worldwide annual travel insurance policy. They have two options:

Option 1: Take out an annual group policy – the cheapest we could find was £132.16

Option 2: Take out one policy for the 40-year-old and the two kids at a cost of £41.08, and a separate policy for the traveller with pre-existing conditions for £68.14. The total cost for both policies would be £109.22 – £22.94 cheaper than the group policy.

However, one thing to be aware of is if, for example, the traveller with pre-existing conditions fell ill and couldn't fly back at the end of the holiday, the 40-year-old and the kids would not get a payout towards the cost of staying on as they have a separate policy. If they were all on the same policy they would all be covered.

Going to Europe? Don't forget your EHIC (it's FREE)

One of the most common areas of travel cover confusion is the role of the free European Health Insurance Card.

An EHIC entitles you to treatment in state-run hospitals in EU countries and Iceland, Norway, Liechtenstein and Switzerland. You'll be treated for the same cost as a local person in the same hospital. So if they pay nowt, you pay nowt.

You can only use hospitals and doctors signed up to the EHIC scheme. If you are in any doubt, check with EHIC before starting treatment. The card should not be used instead of insurance. This is because travel insurance covers far more, including the costs incurred if treatment isn't free, cancellations, delays, repatriation and baggage loss or theft.

The card is free so if a copycat site pretending to the the real thing advertises a fee (often about £25), run a mile. For full info and how to get it for free from the legitimate NHS site, read the Free EHIC guide or by calling 0300 330 1350.

Warning!

Some websites will try to make you pay up to £25 for an EHIC. These look like legitimate sites and rank prominently on Google. They get you to fill in the forms and charge you for 'administration', even though there's no administration needed. See our 60 Seconds on Copycat Sites guide for more.

Technically, no – but you'd be ill-advised not to bother as travel insurance covers you for far more, including medical costs, cancellation, delay, repatriation, baggage loss and theft.

An EHIC should be seen as an extra to travel insurance not a replacement. Travel insurance covers far more scenarios, as well as possessions, delays, repatriation and more. Plus even using an EHIC you may need to pay, and travel insurance will cover that (and often using the EHIC means you don't pay the excess).

Equally many travel insurance exclusions don't apply with EHICs. So If you've been drinking you'll still be treated (not an excuse to push it); or if you've got a pre-existing conditions, it still works. Though medical tourism – going abroad to get treatment – is prohibited.

We've heard reports that some travellers, which was also confirmed by the European Commission, that EHICs were refused in some tourist areas of Spain for public health care. It only affected a minority of travellers in a few areas. See which countries have been affected and what you should do.

Are you already covered?

You may already have travel insurance without knowing. Many bank accounts that charge a monthly fee are likely to have extra benefits such as travel insurance so if you pay for yours you may already be covered. If you think you got insurance as a sweetener with your bank account, check the terms to see if it is appropriate for you.

If your conditions aren't severe, eg, you've got mild asthma, you will probably be covered without paying anything however, if your conditions are severe, you may have to pay an additional fee or you may be declined cover entirely, but always check as insurers have different rules. As Mari, aged 70, found...

I was diagnosed with breast cancer and insurers said I couldn't get cover. I nearly fell off the chair when Nationwide, with the Flex Plus account, quoted £85 for myself and my husband despite my medical history – we've already been to California and are off to South America in November.

If you develop a medical condition you must speak to your bank before you go on holiday. If you don't tell it the condition will not be covered and you may have to foot the bill for overseas treatment if you fall ill.

Do NOT confuse this with a benefit offered with credit cards called travel accident insurance, which only covers accidents on a train, plane or in a hire car paid for on the card. Never think this means you're completely covered.

This insurance should also not be confused with Section 75 legal protection – which covers you if you buy anything that costs between £100 and £30,000 using a credit card (not a debit card). See our Section 75 Protection guide for more on this.

Going on a cruise? You're likely to need an add-on to the policy

Cruise ship holidays are growing in popularity but don't expect to be automatically covered for cruise specific issues. Carefully check your policy to make sure you are covered should you need to cancel a cruise holiday or require medical treatment once on board.

If you need extended cover, which usually includes cover against missed departure, unused cruise excursions, cruise itinerary change and cruise cabin confinement, you can usually select an add-on to get the right protection – which won't break the bank.

Going skiing? Make sure you have winter sports cover

Winter sports can be dangerous, so as soon as you've splashed out on your break, make sure you are insured on the slopes. As well as covering you for the basics you'd get with a pre-existing travel policy, you'll also be insured for activity-related injury and your winter sports equipment.

Travellers with a history of medical problems will not be excluded from taking out winter sports cover and shouldn't have any issues buying it. However, if you are an older traveller you are likely to pay more. In addition, some providers may have limits on their coverage. For example, American Express does not offer winter sports cover to the over-70s, despite offering insurance for travellers up to the age of 79.

Many holidaymakers wrongly assume they're automatically covered for winter sports as part of their travel insurance. While some providers offer winter sports as standard under certain policies, other travel insurers only cover you if you extend your insurance and this will typically cost extra.

All winter sports policies will cover you for skiing and snowboarding and many will also cover other activities, such as husky dog sleigh riding and sledging, as standard. If you are doing something a bit more unusual, such as ski jumping or snowmobiling, check the terms and conditions of your policy first. If you are planning to take part in something even more crazy – such as luging or stunt skiing – specialist providers such as BMC and Snowcard may be able to offer you cover.

If you opt for a specialist travel policy, check your details closely to make sure you know the limits of your cover.

Don't forget to pick your specialist provider like any other travel provider. Make sure you tell your insurer about any pre-existing medical conditions and remember to pack your EHIC if you are going somewhere in Europe.

The cost of medical bills if you get injured on the slopes can be extortionate so it is essential to have cover.

Being airlifted from the mountain to hospital can cost £2,500, repatriation from Europe can set you back £10,000 and you will have to fork out £40,000 if you need to be flown home injured from the US or Canada.

As well as covering yourself, winter sports insurance will also cover your ski pack and cancellation of your holiday.

Most winter sports policies will cover you for accidental damage, theft or the loss of equipment. The onus will be on you to keep your gear safe, so don't leave it at the mercy of crooks.

Your equipment can be covered for up to £3,000, but different providers offer different limits. The sum insured is usually in addition to your standard baggage cover. For example, Axa Direct will cover up to £2,000 worth of equipment with some policies, while Admiral will just cover up to £1,000. Think about the value of your stuff and pick your policy accordingly.

If you've hired ski equipment, it may be covered by your insurer if it's lost, stolen or damaged. Some providers insure any rented kit as part of your baggage up to the limit of the coverage. Other insurers only pay up to 50% of the sum insured for hired equipment. Some ski equipment providers may also cover their gear for you so it is worth checking with the resort before you buy your cover.

In most cases, your ski pack – including ski school fees, a lift pass and hired ski equipment – is covered. The amount can range from £150 to £500, but can be as high as £5,000. As always, check your policy closely for any potential exclusions.

If your piste closes (usually due to lack of snow or an avalanche) and you're unable to hit the slopes, your insurer may give you back a set amount per day. This can range from £10 to £30 – up to a limit of £200 or £300.

Many people aren't aware that if you have an alcoholic drink on holiday, and you lose something or have an accident, your insurance may not cover you – even if you were only a bit tipsy.

It has been known that some insurers have gone as far as testing blood samples of your alcohol level (although we wonder how this works in practice!) but this does vary from policy to policy.

Having a claim refused could hit hard, possibly excluding you from medical or possessions cover.

So check your policy carefully before you buy. The same goes for skiing despite weather warnings and – with some providers – skiing without a helmet.

Don't overpay on your insurance. Costlier cover is rarely worth it

As you're buying a travel insurance policy for someone with pre-existing conditions, you're going to be paying more than someone with a clean bill of health. However, remember to watch out for insurance providers as they go all out to scare us into upping cover levels.

Don't be duped into upgrading for no reason. Platinum policies with £10m medical cover, even if you have pre-existing medical conditions, are bunkum.

"Why," you ask? Well, you're charged more but the chances of you making a claim that high are slim. According to the Association of British Insurers, the average cost of a medical travel insurance claim in 2013 was £930 – a far cry from £10m!

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Cover for pre-existing conditions

Whether you're travelling in Europe or further afield, with your family or on your own, follow the steps below to find the right cover at the right price. These steps apply for single and annual policies and if you have severe medical conditions, a single policy may be the most affordable option.

Do you need pre-existing cover?

Some conditions are more difficult to cover than others, so consider your needs carefully. If you have, or have had, mild asthma or high-blood pressure you may still be able to get cover via our main travel insurance guide.

Remember that you must tell your insurer about your condition – even if you don't deem it particularly serious.

If you've got a serious condition, you'll need specialist cover

More serious conditions, such as certain heart conditions or cancer, are likely to need specialist cover.

As an alternative, if you have a free EHIC card – which means you can use an EU state run hospital for the same price as a local – then EHIC plus* may be useful. It covers most pre-existing conditions, if you've used an EHIC card, and also gives you all the other usual things travel insurance covers such as delays, baggage and cancellation. Remember – it's not Government-backed, the underwriter is Mapfre Insurance.

Check the specialists comparisons miss

There are a number of insurers which specialise in giving policies to those with pre-existing medical conditions which aren't listed on comparison sites – but there are no hard or fast rules so get quotes from as many as you can.

Contact a broker

What to do in the worst case scenario

If cover is still unaffordable, the price may drop considerably if you ask insurers to exclude some, or all, of your pre-existing conditions. Overall, it is a judgement call on the risks of travelling with limited cover.

How to claim on your travel cover

Claiming on your travel insurance shouldn't be daunting and – if you understand the terms and excesses on your policy – you shouldn't be in for any nasty shocks. Follow the five steps below in the event you need to claim.

Submit your claim as soon as possible

Contact your insurer as soon as you can. Some parts of your policy may have a short window to submit a claim and it may take a while to be processed.

If it's a medical claim get an insurer to accept it first

If you need to make a medical claim – and it is not an emergency – get an insurer to accept the claim over the phone first. For example, thieves make off with medicine kept in a handbag that you need urgently. If the insurer accepts the claim over the phone, you're less likely to be faced with a rejected claim later down the line. For obvious reasons, don't delay treatment if it is an emergency.

If it's a theft or loss claim notify the police

If something goes missing or is stolen when you are abroad you may need to get a crime reference number or the overseas equivalent to make a successful claim. Report the incident to the police as soon as you can – you often have to do it within 24 hours to be able to claim – to make sure your claim doesn't hit the skids.

Keep your receipts

If you are claiming for lost luggage or delay, remember to keep receipts of essential items you have bought in the interim, such as food and drink. Many insurers allow you to add these expenses to a claim and may ask for receipts as proof.

Complain if you feel your claim was unfairly rejected

If your insurance company rejects your claim, and you think it has done so wrongly, do not take it lying down. Complain to the free Financial Ombudsman. It's an independent adjudicator which will make the final decision on a claim if you are locked in a dispute with your insurer. For more on how to make a complaint, read our Financial Rights guide.

How to complain about your insurance provider

The insurance industry doesn't have the best customer service reputation and while a provider may be good for some, it can be hell for others. Common problems include claims either not being paid out on time or at all, unfair charges, or exclusions being hidden in the small print. It's always worth trying to call your provider first, but if not then…

Free tool if you're having a problem

This tool helps you draft your complaint and manage it too. It's totally free, and offered by a firm called Resolver which we like so much we work with it to help people get complaints justice.

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